Prostate Cancer Treatment in Mumbai, India

Overview

Prostate cancer is a type of disorder that affects the prostate, a walnut-shaped gland that produces a fluid used to nourish and transport sperm. The prostate is part of the male reproductive system, located in front of the rectum and below the bladder. Prostate cancer is characterized by the uncontrolled growth of cells in the prostate gland, which, left untreated, may spread to neighboring tissues and other body parts.

Associated Anatomy

Prostate gland

Causes of Prostate Cancer

There is a lack of consensus as to what exactly causes cells in the prostate gland to exhibit controlled growth. However, a couple of factors contribute to prostate cancer in several individuals.

Genetic predispositions- An individual is likely to get prostate cancer if their blood relative, such as a parent, child, or sibling, is diagnosed with it.
Mutations- Inherited (acquired from parents) mutations in specific genes like BRCA1 and BRCA2 have been shown to cause prostate cancer.

Signs or Symptoms of Prostate Cancer

In the incipient stages of prostate cancer, signs or symptoms rarely occur. However, as prostate cancer advances, the following signs and symptoms may be observed-

Painful urination (dysuria)
Increased inclination to urinate frequently, especially at night.
Blood in the sperms (Hematospermia) or blood in the urine (hematuria).
Difficulty in getting an erection (erectile dysfunction).
Painful ejaculation.
Pain near the pelvis region, lower back, or hip region.
Numbness in feet or leg

Prostate Cancer Treatment

There are various options available for prostate cancer treatment. Treatment options vary between individuals and mainly depend upon prostate cancer's extent and stage. Some prostate cancer treatment options include-

Watchful waiting and active surveillance- If the doctor thinks that prostate cancer will not multiply rapidly, they will closely monitor the development of prostate cancer using diagnostic tests.
Prostatectomy- A surgery in which the prostate gland is removed. Sometimes, surrounding tissues are also removed.
Radiation therapy- In radiation therapy, high-energy radiation kills cancer cells. There are two types of radiation therapy- brachytherapy (also known as internal radiation therapy) and external radiation therapy.
Focal therapies- These therapies are recommended if the cancer is localized to a specific part of the prostate. Cryotherapy, photodynamic therapy, laser ablation, and high-intensity focused ultrasound (HIFU) are some focal therapies recommended for prostate cancer patients.
Systemic therapies- Systemic therapies include chemotherapy, immunotherapy, and hormone therapy. These are usually suggested if cancer spreads to other body parts.

Prostate Cancer Risk Factors

Following are some risk factors associated with prostate cancer-

Age- The risk of developing prostate cancer increases with age.
Ethnicity- Dark-skinned individuals have the highest risk of getting prostate cancer.
Family history- An individual's risk of prostate cancer increases if their blood relative is diagnosed with prostate cancer.
Obesity- People who are obese are at a higher risk of developing an advanced form of prostate cancer.

Stages of Prostate Cancer

Doctors assign the stage of prostate cancer based on the Gleason scoring system and TNM staging system. The following are the stages of prostate cancer-

Stage I- cancer is typically slow-growing and cannot be felt easily.
Stage II- The tumor is small, but there is an increased risk of growth and spread to neighboring tissues. Stage II can be further classified into stages IIA, IIB, and IIC.
Stage III- In stage III, the tumor is classified as high grade, and it is likely to spread to other parts of the body. It can be subdivided into stages IIIA, IIIB, and IIIC.
Stage IV- Stage IV is characterized by the spread of the tumor to other parts of the body. Depending upon the affected body part, it is classified into stage IVA and stage IVB.

Typical Test

Doctors often begin their diagnosis by evaluating a patient’s medical history, symptoms, and associated risk factors. Some of the tests that are generally recommended for diagnosis include-

Digital rectal examination- A healthcare provider inserts their gloved, lubricated finger into the rectum to examine possible tumors on the prostate.
Prostate-specific antigen (PSA) test- PSA is a protein produced by the prostate gland. This test estimates the level of PSA in the blood. Elevated levels usually indicate prostate cancer.
Biopsy of the prostate- This test involves removing small prostate tissue for tumor examination.

Prevention

Primary prevention

Some of the lifestyle modifications that can be adopted to reduce the risk of prostate cancer include-

Having a nutritious and a healthy diet
Exercising regularly.
Maintaining a healthy body weight.
Abstinence from smoking.

Secondary prevention

Active follow-up- Having regular follow-up meetings with the doctor will help in reducing the risk of cancer recurrence. The doctor will recommend tests to monitor the PSA levels.
Lifestyle modifications- Exercising regularly and having a healthy diet decreases the risk of recurrence.

Epidemiology

Prostate cancer is the second most cancer affecting the male population (after skin cancer), and about 1 in 9 men are diagnosed with prostate cancer during their lifetime. In 2018, about 1,276,106 cases of prostate cancer were registered worldwide. Dark-skinned males are at a higher risk of developing prostate cancer, with over 60 % of cases occurring in the population over 65 years of age.

Expected Prognosis

Since prostate cancer grows slowly, most men survive cancer. Early diagnosis of prostate cancer holds the key to positive outcomes.

Natural Progression

In most individuals, the tumor grows slowly and becomes localized to the prostate gland. However, if cancer is left untreated, it spreads to adjoining tissues and other parts of the body. This may lead to life-threatening complications.

Pathophysiology

Prostate cancer is characterized by the uncontrolled growth of cells in the prostate gland. This occurs when the rate at which a cell divides exceeds the rate at which it dies, leading to the tumorous growth of cells.

Possible Complications

If left untreated, prostate cancer can spread to nearby organs like the bladder, a process referred to as metastasis. The tumor could also travel through blood vessels or lymph nodes to other parts of the body. Other complications of prostate cancer include urinary incontinence and erectile dysfunction.

Surgery, radiation therapy, chemotherapy and hormone therapy, along with close monitoring and observation, are the most common treatment modalities for prostate cancer. The treatment plan depends on factors such as the stage of the cancer, the patient's age and overall health.

The success rate of prostate cancer treatment depends on various factors, including the stage of cancer at the time of diagnosis, the treatment method used, and the patient's overall health. Early detection and treatment of prostate cancer offers the best chance of positive, long-term outcomes.

The side effects of prostate cancer treatment depend on the treatment method. Surgery may cause urinary incontinence, erectile dysfunction, and bowel problems. Radiation therapy may cause fatigue, skin irritation, and bowel problems.

Yes, prostate cancer treatment is possible without surgery or radiation therapy. Watchful waiting and active surveillance may be recommended for patients with early-stage prostate cancer or those with other health problems that make surgery or radiation therapy too risky.

Recovery time from prostate cancer treatment varies depending on the treatment method used and the patient's overall health. Some patients may recover within a few weeks, while others may take several months.

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Prostate Cancer